ACUSON Maple FAST and eFAST Presentation

SIEMENS Healthineers FAST and eFAST Ultrasound Training 1 Unrestricted © Siemens Healthineers 2020 Overview SIEMENS Healthineers • Define the FAST Exam • Explain the FAST Views • What is the eFAST Exam? • Transducer Overview • Review Preferred Presets 2 Unrestricted © Siemens Healthineers 2020 FAST Exam SIEMENS Healthineers What is a FAST exam? Focused Assessment with Sonography in Trauma (FAST) exams is a rapid bedside ultrasound examination performed by physicians as a screening test for blood around the heart (pericardial effusion) or in the abdomen (hemoperitoneum) after trauma. Four views of the abdomen • Right upper quadrant • Subxiphoid view • Left upper quadrant • Suprapubic view 3 Unrestricted © Siemens Healthineers 2020 Right Upper Quadrant View SIEMENS Healthineers Rt Upper Quadrant / Perihepatic View • Image liver and kidney interface looking for fluid collections in the Morison’s pouch as well as the paracolic gutter area. • Place probe on the right side of the abdomen on the anterior surface and slide laterally to assess the liver / kidney interface. • Slide inferior to visualize the inferior pole of the right kidney and assess the paracolic gutter area for any dependent fluid collections. 4 Unrestricted © Siemens Healthineers 2020 Subxiphoid View SIEMENS Healthineers Subxiphoid / Subcostal or Pericardial View • Image the heart to assess for pericardial effusion. Pericardial effusion is a disease state where fluid builds up in between the visceral and parietal pericardium space. • Place the probe in the epigastric region and apply pressure as you angle the probe superiorly. You should see the heart and will see hypoechoic fluid surrounding the heart. Depending on the origin of the fluid (serous fluid, blood, infection), the fluid may look hypoechoic, complex or solid. • If you are unable to scan the epigastric region, parasternal or apical four chamber view may be used. 5 Unrestricted © Siemens Healthineers 2020 Left Upper Quadrant View SIEMENS Healthineers Left Upper Quadrant or Perisplenic View • Image the left upper quadrant to assess the spleen and left kidney looking for fluid in the perisplenic spaces. • Place probe on the left side of the abdomen on the 15 cm anterior surface and slide laterally to assess the spleen and left kidney interface. • Special attention to the echogenicity of the spleen should interrogated. Splenic rupture with trauma is common. The spleen is normally seen as a homogenous organ but with trauma there will be heterogenous area with hyper or hypoechogenic areas seen. 6 Unrestricted © Siemens Healthineers 2020 Suprapubic View SIEMENS Healthineers Suprapubic or Pelvic View • Image the pelvic area for fluid collection. • Place probe on the lower abdomen just superior to the symphysis pubic bone. If the bladder is full, you will see the bladder as a hypoechoic fluid filled 15 cm structure. Fluid will accumulate in the dependent peritoneal space. • Sweep in a transverse plane using the bladder as an acoustic window to see the posterior rectovesical space for free fluid. 7 Unrestricted © Siemens Healthineers 2020 eFAST Exam SIEMENS Healthineers What is a eFAST exam? Extended Focused Assessment with Sonography in Trauma (eFAST) exams is a rapid bedside ultrasound examination performed by physicians as a screening test for blood around the heart (pericardial effusion) or in the abdomen (hemoperitoneum) after trauma. It contains the FAST exams views and adds two additional views to assess the lungs. Five views of the abdomen and thorax • Right upper quadrant • Subxiphoid view • Left upper quadrant • Suprapubic view • Right and Left thoracic views 8 Unrestricted © Siemens Healthineers 2020 Lung View SIEMENS Healthineers Lung View or Anterior Pleural View • Image the chest cavity to assess for pneumothorax and pleural effusions. • Place probe on the anterior chest at the midclavicular line between the clavicle and the diaphragm. 12 0m • Hold the transducer still and look for lung sliding with respiration or lung pulse seen with the beating of the heart. If these signs are missing, it is suggestive of pneumothorax. • Slide the transducer laterally to assess dependent portion of lung cavity to visualize any pleural effusions that may collect in the dependent position of the chest cavity. 9 Unrestricted © Siemens Healthineers 2020 Transducer Overview SIEMENS Healthineers Linear Array • Used to assess superficial structures • Good for pleural lining assessment Curved Array • Adequate transducer for FAST and eFAST exams but not preferred for cardiac evaluations Phased Array • Preferred transducer for FAST and eFAST exams • Able to penetrate adequately to see abdominal and thoracic cavities • Able to visualize the heart using parasternal and apical scan views • Easy to scan intercostal on obese patients 10 Unrestricted © Siemens Healthineers 2020 Presets SIEMENS Healthineers ACUSON Juniper 5C1 2L3 5P1 Lung Add Exam • FAST preset is available for all transducers ? Abd Venous GYN OB O Close Renal Arterial Pelvis Early OB Edit ACUSON P500 Bowel Spine Fetal Echo • Use abdominal preset and increase Clear depth to 14 – 16 cm Screen FAST OB (Adv) Hide • Save preset as FAST or eFAST or user Patient Lung defined preset Image Param End Exam ACUSON Freestyle • Select abdominal preset and increase depth to 14 – 16 cm • Save preset as FAST or eFAST user defined preset 11 Unrestricted © Siemens Healthineers 2020 Disclaimers SIEMENS Healthineers All information in this presentation is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any healthcare practitioner reading this information is reminded that they must use their learning, training, and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Solutions USA, Inc. to be used for any purpose in that regard. 12 Unrestricted © Siemens Healthineers 2020 Disclaimers SIEMENS Healthineers Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. 13 Unrestricted © Siemens Healthineers 2020